VA researcher Dr. Michelle Marie Hilgeman is conducting a study that will examine the effectiveness of a Montessori-based therapy for Veterans who live in VA community living centers (CLCs).

Because a significant majority of Veterans who live in CLCs have some form of dementia and/or mental illness (69 percent), there is a need for programs that can address negative behavioral issues like shouting or combativeness.

Montessori-based Activity Programming (MAP) is a nursing-home intervention that uses structured activities to help residents become more socially and cognitively engaged. The activities must be meaningful to Veterans and often are modeled after activities that are familiar, like gardening or wood-working.

During phase I of the program, investigators at the Tuscaloosa VA Medical Center in Alabama developed and tested the MAP program materials and training manual at four CLC sites. During phase II, they will further refine the training materials and roll out implementation at six CLC sites. The MAP program traditionally requires a lengthy training period for nursing-home staff. Part of this study involves comparing the results of an in-person training program to one that is delivered remotely via conference calls.

At the conclusion of phase I, Veterans who went through the MAP showed a decrease in agitation and a reduction in the need for psychotropic medications. Veterans have also demonstrated improvement in orientation to place and are participating in more center activities.

The Montessori Method was originally developed for use in children who had developmental disorders in the early 1900s by Dr. Maria Montessori. It was later modified for use in children with normal intelligence. It is an early childhood education program that stresses independence, freedom of choice, and self-determination. It is now being used to help address behavioral issues in people who have dementia.